Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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The Surgical Release of Dupuytren's Contracture Using Multiple Transverse Incisions

  • Lee, Hyunjic (Department of Plastic and Reconstructive Surgery, Dongguk University Ilsan Hospital, Dongguk Graduate School of Medicine) ;
  • Eo, Surak (Department of Plastic and Reconstructive Surgery, Dongguk University Ilsan Hospital, Dongguk Graduate School of Medicine) ;
  • Cho, Sanghun (Department of Plastic and Reconstructive Surgery, Dongguk University Ilsan Hospital, Dongguk Graduate School of Medicine) ;
  • Jones, Neil F. (Hand and Upper Extremity Surgery Center, University of California Irvine)
  • Received : 2012.04.24
  • Accepted : 2012.06.19
  • Published : 2012.07.15
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Abstract

Dupuytren's contracture is a condition commonly encountered by hand surgeons, although it is rare in the Asian population. Various surgical procedures for Dupuytren's contracture have been reported, and the outcomes vary according to the treatment modalities. We report the treatment results of segmental fasciectomies with multiple transverse incisions for patients with Dupuytren's contracture. The cases of seven patients who underwent multiple segmental fasciectomies with multiple transverse incisions for Dupuytren's contracture from 2006 to 2011 were reviewed retrospectively. Multiple transverse incisions to the severe contracture sites were performed initially, and additional incisions to the metacarpophalangeal (MCP) joints, and the proximal interphalangeal (PIP) joints were performed if necessary. Segmental fasciectomies by removing the fibromatous nodules or cords between the incision lines were performed and the wound margins were approximated. The mean range of motion of the involved MCP joints and PIP joints was fully recovered. During the follow-up periods, there was no evidence of recurrence or progression of disease. Multiple transverse incisions for Dupuytren's contracture are technically challenging, and require a high skill level of hand surgeons. However, we achieved excellent correction of contractures with no associated complications. Therefore, segmental fasciectomies with multiple transverse incisions can be a good treatment option for Dupuytren's contracture.

Keywords

References

  1. Sladicka MS, Benfanti P, Raab M, et al. Dupuytren's contracture in the black population: a case report and review of the literature. J Hand Surg Am 1996;21:898-9. https://doi.org/10.1016/S0363-5023(96)80211-5
  2. Ahn HC, Cheon HJ, Kim KC, et al. Dupuytren's contracture felease with straight line incision and multiple Z-plasty. J Korean Soc Surg Hand 2011;16:35-41.
  3. Hurst LC, Badalamente MA. Nonoperative treatment of Dupuytren's disease. Hand Clin 1999;15:97-107.
  4. Hueston JT. Limited fasciectomy for Dupuytren's contracture. Plast Reconstr Surg Transplant Bull 1961;27:569-85. https://doi.org/10.1097/00006534-196106000-00001
  5. Honner R, Lamb DW, James JI. Dupuytren's contracture. Long term results after fasciectomy. J Bone Joint Surg Br 1971;53:240-6.
  6. Elliot D. The early history of Dupuytren's disease. Hand Clin 1999;15:1-19.
  7. Tomasek JJ, Vaughan MB, Haaksma CJ. Cellular structure and biology of Dupuytren's disease. Hand Clin 1999;15:21-34.
  8. Seyhan H, Kopp J, Schultze-Mosgau S, et al. Increased metabolic activity of fibroblasts derived from cords compared with nodule fibroblasts sampling from patients with Dupuytren's contracture. Plast Reconstr Surg 2006;117:1248-52. https://doi.org/10.1097/01.prs.0000204585.97844.7e
  9. Reilly RM, Stern PJ, Goldfarb CA. A retrospective review of the management of Dupuytren's nodules. J Hand Surg Am 2005;30:1014-8. https://doi.org/10.1016/j.jhsa.2005.03.005
  10. Rowley DI, Couch M, Chesney RB, et al. Assessment of percutaneous fasciotomy in the management of Dupuytren's contracture. J Hand Surg Br 1984;9:163-4. https://doi.org/10.1016/S0266-7681(84)80019-4
  11. Moermans JP. Segmental aponeurectomy in Dupuytren's disease. J Hand Surg Br 1991;16:243-54. https://doi.org/10.1016/0266-7681(91)90047-R
  12. Hurst L. Dupuytren's contracture. In: Green D, Hotchkiss R, Pederson WC, editors. Operative hand surgery. 5th ed, New York: Churchill Livingstone; 2005. p. 159-85.
  13. Bruner JM. The zig-zag volar-digital incision for flexor-tendon surgery. Plast Reconstr Surg 1967;40:571-4. https://doi.org/10.1097/00006534-196740060-00010
  14. McCash CR. The open palm technique in Dupuytren's contracture. Br J Plast Surg 1964;17:271-80. https://doi.org/10.1016/S0007-1226(64)80043-6
  15. Clibbon JJ, Logan AM. Palmar segmental aponeurectomy for Dupuytren's disease with metacarpophalangeal flexion contracture. J Hand Surg Br 2001;26:360-1. https://doi.org/10.1054/jhsb.2001.0602

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